5-ASA Discontinuation Common Within First Year of Ulcerative Colitis Diagnosis in Youth

Discontinuation rate higher for those aged 18 to 24 years versus younger age groups
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WEDNESDAY, Sept. 20, 2023 (HealthDay News) -- For adolescents and young adults diagnosed with ulcerative colitis (UC), the rate of discontinuation of 5-aminosalicylic acid (5-ASA) maintenance treatment is high within the first year, according to a study published online Sept. 4 in the British Journal of General Practice.

Nishani Jayasooriya, M.B.B.S., from St. George’s University Hospitals NHS Foundation Trust in London, and colleagues examined the rates and risk factors for discontinuation and adherence to oral 5-ASA in adolescents and young adults one year after UC diagnosis in an observational cohort study. The impact of sociodemographic and health-related risk factors was assessed.

The researchers found that 152 of 607 adolescents and young adults starting oral 5-ASA maintenance treatment discontinued within one month, and 419 discontinued within one year. Those aged 18 to 24 years had higher discontinuation than younger age groups (74 percent versus 61 and 56 percent in those aged 10 to 14 and 15 to 17 years, respectively). Compared with adolescents, young adults had lower adherence (69 versus 80 percent in those aged 18 to 24 versus 10 to 14 years). The likelihood of discontinuing treatment was increased for residents in deprived versus affluent postcodes (adjusted hazard ratio, 1.46). A lower likelihood of discontinuation was seen for early corticosteroid use for an acute flare (adjusted hazard ratio, 0.68).

"These findings illustrate the importance of clinicians ensuring careful follow-up within the first year when prescribing lifelong therapies for adolescents and young adults who are diagnosed with UC, particularly adolescents transitioning to young adulthood and those living in deprived areas," the authors write.

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